Over time, society and medicine have progressed, pushing tradition, ritual, superstition, and religion aside in favour of more evidence-based practices. Blood transfusions replaced leeches and daily medicine replaced prayers. Yet still today, faith-based practices are the main source of healing for many communities internationally. Faith healers, who are traditionally trusted and respected members of many societies around the world, have the ability to provide certain services that can be invaluable for individuals suffering from a variety of ailments.
However, it must also be acknowledged that a lack of proper medical attention and a reliance strictly on religion or ritual to treat illness can lead to further pain or even death.
From this dependence on “alternative” medicine (oftentimes overlooked and swept aside by Western institutions and academia) has emerged an obstacle that can hinder grassroots organizations from providing sufficient medical care to villages that could greatly benefit from their services. It is widely accepted within the modern medical community that pharmacologically active agents (medicine) and physical interventions (surgery) are dependable treatments that can help save lives. At the same time, faith healers have developed a trust in families and individuals which urban-based organizations may not naturally have.
This makes access to rural communities problematic and creates friction between healthcare professionals and the villages they are trying to serve. Hostility towards organizations makes communication and dialogue difficult between a community and a healthcare professional. These professionals often respond to this hostility with condescension and cultural insensitivity. The result is disastrous, and can potentially prevent a well meaning mission from giving services to those who deserve them. What is oftentimes not recognised is that both the foreign (at least to the village) and local practices provide important services to the village.
When working in rural communities, it is imperative to find a balance between the two. Raghu Appasani seems to have struck this equilibrium with the MINDS Foundation, a grassroots organisation which he founded, dedicated to educating rural Indian communities about the truth behind mental illness, in order to unpack stigma and make life for those suffering with mental illness externally easier. Appasani is also a One Young World ambassador and spoke at the One Young World Summit in 2016 about the challenges of curing the stigma of mental health in rural India.
Internationally, mental health is still a highly misunderstood facet of the medical world. Although some mental illnesses like epilepsy and schizophrenia have physical symptoms, many don’t. This includes depression, which according to the World Health Organisation, affects approximately 350 million people worldwide, about 5 per cent of the population. In India, the numbers are around the same, but, combined with anxiety disorders, this climbs to 7.5 per cent. It is important to keep in mind that much of the population is unaccounted for.
When suffering from a mental illness like depression, internal distress may manifest outwardly in antisocial behaviour, fits of crying, or aggression. These can easily be interpreted as ungratefulness or laziness, which further isolates the individual who is suffering. If their family or community rejects them, there is a high possibility the person who is depressed may resort to suicide. In India, 16 for every 100,000 people end their own life. There is an increased risk in rural communities, as they may lack the education to contextualise mental illness. More drastic is the blunt fact that India now has the highest rate of youth suicide in the world, standing at 36 per 100,000.
The MINDS Foundation understands that mental illness is a “highly stigmatized and deeply personal health issue” and they are “committed to a bottom-up, grassroots approach based on education, front-line healthworker empowerment, partnerships with local communities, health workers, and other stakeholders”.
In this way, there is an integration of the local and the foreign, a melding of knowledge which creates an understanding about mental health that can encourage acceptance within rural communities.
According to the MINDS Foundation website, 395 patients have been treated, over 75,000 people have been screened, access has been provided for 250,000 people, and 7,500 children have been educated. These numbers are huge, especially considering every person treated is potentially avoiding ending their own life.
This would not have been possible if the foundation had disregarded the role of the faith healers in the communities they reached out to. Appasani stresses that the majority of faith healers are “super beneficial” as they provide “talk therapy and important moral support” as well as other treatments which have been practiced and trusted for generations. One of his goals moving forward with the organisation is “working with faith healers further and having them as a referral point or (utilising them for) counselling services”.
This is not to say that faith based doctors are always completely reliable. As with any religious centred practice, belief is one of the core principals, and sometimes belief does not cut it when treating a mental health issue. Appasani mentioned visiting one village where the last resort to remove the “demon” inside the patient was visiting a temple with their healer and having their hair pulled.
Another issue that emerges with faith healers is the business side of their role in the community. It is easy to forget that this is their job, and how they provide for themselves or their families. Appasani made it clear that this added an element of cautiousness to their foundation when entering a village, because if one replaces a faith healer with access to a psychiatrist at a clinic, you are stripping that faith healer of their livelihood. Like any religious organisation, monetary compensation can occasionally provide a conflict of interest for the patient and provider. Similar to the way a priest may take advantage of the weekly donations, Appasani described how sometimes faith healers can take advantage of their communities. For example, “selling beads to everybody else (in the village) as a way to fight off the demons that one patient has”. This lucrative side of healing can be problematic, but is a common occurrence worldwide when religion intersects with society.
As far as pushback from healers, Appasani says that “most of them” are open to talking to his foundation, and at the moment, the MINDS Foundation is focusing on assessing the knowledge of faith healers about mental health to develop educational curriculum for them. Their research so far has shown that many of the faith healers “are quite educated about various mental health issues”. Although there have been occasional negative interactions, Appasani says 90 per cent of them have been positive. He makes it clear that his organisation doesn’t “tell people not to go to faith healers,” but instead offers “another option, medically”, and overall, both services should be complimentary.
The MINDS Foundation seems to find a plethora of balances which make it the productive, progressive, and influential on the international medical stage today. The balance is between acknowledging that mental illness cannot be erased from a society, but stigma can be. The understanding that alternative medicines hold great value in rural communities, whilst still attempting to educate on the importance of western-medicinal intervention and providing services when necessary. A common thread through this is the mission of acceptance – acceptance of unfamiliarity and acceptance of difference. A core belief that should be adapted worldwide.